Betel leaf or ‘Paan’ (Piper betel L.), an integral component of the chewing stimulant ‘betel quid’, is a common traditional practice in India with multi-million consumers. The current study focuses on the traditional preparation of betel quid and the pivotal role of betel leaf in medico-socio-religious use in Bhadrak district, Odisha, India. Information on the utilization of Piper betel was gathered from 83 informants of various ages in different villages of the district by using questionnaires, complemented by free interviews, informal conversations, and direct observations. Traditionally, the tender stalk of the leaf dipped in castor oil is introduced in the anus for constipation. The juice of the leaf is dropped into the ear to relieve earache and 1-2 leaf is taken orally for indigestion. The result revealed three types of betel quid (Kada paan, Sadha paan, and Raja paan) all of which have a basic combination of majorly Piper betel leaf, areca nut, catechu, and slaked lime with variable additional ingredients depending on the local practices or taste. A mixture commonly called gundi is usually used for kada paan. Traditional paan is being used as a post-meal digestive stimulant. Among the services, the offering of paan (only betel leaf and areca nut) is one of the forms of expressing reverence to Hindu deities. Piper betel leaf received sastric sanction as an article of use in socio-religious rituals and ceremonies such as those connected with birth, marriage, and death. Again, offering paan to guests is a standard form of hospitality in Hindu homes.